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HIV co-infection is not associated with accelerated progression of liver fibrosis in people with hepatitis C virus (HCV) infection, according to US research published in the online edition of the Journal of Infectious Diseases. Factors linked with fibrosis progression were low fibrosis stage at baseline and flares in alanine aminotransferase (ALT) levels.
The major strengths of the study were its large sample size and the fact that participants had at least two liver biopsy results during follow-up, Dr Daniel S Frierer of Mount Sinai Hospital, New York, commented in an accompanying editorial.
HCV is a leading cause of serious liver disease. The infection can cause progressive liver fibrosis, cirrhosis, liver cancer and death. Effective therapies are now available. However, these treatments are costly and it is therefore necessary to prioritise people in greatest need, especially those experiencing rapid fibrosis progression.
As the factors associated with the progression of liver fibrosis in the context of HCV infection are poorly understood, investigators from Cornell Medical College, New York, designed a retrospective study to determine the rates and risk factors for disease progression. The research involved 378 people with HCV infection who had two or more liver biopsies between 1997 and 2013. The investigators analysed the effect of demographic, epidemiological and virologic factors on progression of fibrosis.
The authors … point out that their findings call into question the assumption that fibrosis progresses at a steady, or linear, rate, and they conclude, “we found varying stage-specific progression rates in patients with chronic hepatitis C.”